How am I Responding to Treatment?
Following removal of supra and sub gingival plaque -(that’s plaque above and below the gum), you should see a bit of reduction in pocket depth as the swelling in the gums has now subsided.
You may experience some recession of your gums (1-2mm could be expected) and there should be less bleeding, as your gums are now tougher and no longer inflamed. Because smoking reduces swelling (inflammation) and bleeding of your gums anyway, the response to treatment in a smoker is less obvious.
In some cases you may find your teeth also firm up a bit and are not quite as loose as they were before. This is a really good sign. If all this happens, then you have responded well to treatment.
Now it is a matter, as I have said many times, of keeping your mouth plaque free at home and regularly checking in with your dentist to monitor your progress. Visit the care section and learn how to do it once and for all!
A poor response to treatment would be very little or no change to probing depths, swelling and bleeding.
It is worth noting that in some cases of severe disease, extensive calculus build up can actually sort of splint the teeth in position and when this is removed, the teeth all of a sudden become quite loose. Your dentist should warn you if they think this will happen.
Why do I Need a Maintenance Programme?
After initial charting and a course of periodontal treatment has been completed, your dentist will put you on an appropriate maintenance programme. Named so, because we are trying to maintain the levels of bone and support for your teeth.
Periodontitis is not a reversible disease, you don’t suddenly grow new bone to support your teeth. You have the disease for life and it is thought that it progresses in phases, stable periods followed by periods of disease activity that can cause further bone loss around your teeth. Because of this, and the fact that we can’t predict when it will happen, it is important we continue to keep a careful eye on things- this is the purpose of the maintenance program.
How your dentist designs this programme depends on a number of things including the number of risk factors for gum disease you have, the progression of your disease and the level of your oral hygiene and plaque control. They will also take into account how severe the disease was when you first presented, how easy treatment was to perform and how your gums responded.
We recommend that most people see a dentist every 6 months, but when it comes to gum disease, this is a little different. Most dentists will want to see you every 3 months, although this will depend on your susceptibility and the points raised above. It can be as often as 2 months or for more resistant individuals, 4 months or even (once you have proved you can keep things amazingly clean) just the regular 6 monthly check.
A lot of the time non-surgical treatments (cleaning above and below the gums) and recall evaluations will be carried out by the hygienist at the practice, but a dentist should review your progress and adjust the intervals as necessary at least once a year.
What goes on at a Maintenance Appointment?
- Checking of your teeth for plaque and bleeding
- A review of your plaque control and re-enforcement of brushing, flossing and inter-proximal brushuse
- A check on your probing depths and comparison to measurements taken previously i.e. updating your periodontal chart
- A supragingival (above the gum) clean
- Removal of subgingival (below the gum) plaque and calculus from any pockets still over 4mm deep. This may require another appointment.
These simple techniques can keep things at bay in most patients who suffer from gum disease. Often you will see significant and even dramatic improvements, that will leave you will a much healthier and happier mouth and body.
Once you have got to a point where your mouth consists entirely of normal probing depths of 1-3mm with little or no bleeding on probing, you can maintain your mouth with simple regular care as any other healthy patient would.